抑郁症自杀未遂与甲状腺激素、血浆皮质醇关联分析  

Analysis of the relationship between attempted suicide and thyroid hormone and plasma cortisol in depres⁃sion

作　　者：王艳华[1] 杨永涛 崔利军[1,2] 崔伟 高景娜[1] 郑冬瑞[1] WANG Yanhua;YANG Yongtao;CUI Lijun;CUI Wei;GAO Jingna;ZHENG Dongrui(Hebei Mental Health Center,Baoding 071000,China;不详)

机构地区：[1]河北省精神卫生中心,河北保定071000 [2]济宁医学院,山东济宁272000

出　　处：《实用医学杂志》2021年第16期2044-2047,2052,共5页The Journal of Practical Medicine

基　　金：河北省财政厅河北省卫生健康委政府资助临床医学优秀人才项目(编号:361014)。

摘　　要：目的探讨抑郁症患者自杀未遂与甲状腺激素、血浆皮质醇之间的关系。方法符合DSM⁃5抑郁发作诊断标准患者158例,评估是否出现自杀未遂,将患者分为自杀未遂组和非自杀未遂组,评估汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA),测量甲状腺激素、血浆皮质醇。结果自杀未遂组促甲状腺激素(TSH)、游离甲状腺素(FT4)明显低于非自杀未遂组(P<0.05),自杀未遂组HAMD量表总分高于非自杀未遂组(P<0.05),两组间血浆皮质醇未见差异。按年龄分层,<40岁自杀未遂组FT4水平明显低于非自杀未遂组(P<0.05)。多因素logistic回归分析显示:FT4(OR=0.029)、TSH(OR=0.399)、阳性家族史(OR=5.203)、HAMD量表评分(OR=1.207)为独立危险因素。结论自杀未遂组抑郁症存在甲状腺激素紊乱。家族史阳性,疾病严重程度重,FT4、TSH越低的患者自杀风险更高,<40岁患者更应关注FT4水平。Objective To explore the relationship between attempted suicide and thyroid hormone and plasma cortisol in patients with depression.Method A total of 158 inpatients who met the diagnostic criteria of DSM⁃5 depressive episode were collected.The patients were divided into two groups:those with a history of suicide attempted and those without a history of suicide attempted.Hamilton Depression Scale(HAMD)and Hamilton Anx⁃iety Scale(HAMA)were used to assess the severity of depression and anxiety,respectively.The plasma concentra⁃tions of thyroid hormone and cortisol were measured.Result The levels of TSH and FT4 in attempted suicide group were significantly lower than those in non⁃attempted suicide group(P<0.05).Total HAMD scores were higher in attempted suicide group compared with non⁃attempted suicide group(P<0.05).No differences in the plasma cortisol levels were found between the two groups.According to the age stratification,the level of FT4 in the attempted suicide group under 40 years old was significantly lower than that in the non⁃attempted suicide group(P<0.05).Multivariate logistic regression analysis showed that FT4(OR=0.029),TSH(OR=0.399),positive family history(OR=5.203)and HAMD score(OR=1.207)were high risk factors.Conclusion There is a thyroid hormone irregular in depression with attempted suicide.The patients with positive family history and severe disease,the lower levels of FT4 and TSH,the higher risk of suicide,and the patients less than 40 years old should pay more attention to the level of FT4.No correlation between plasma cortisol and attempted suicide is found in this study.

关 键 词：抑郁症 自杀 皮质醇 甲状腺激素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]